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  • Effects of Ambroxol on the Transfer of Ceftizoxime into the Ethmoid Cell Mucosa.

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Ceftizoxime and ambroxol were administered in combination to patients with chronic sinusitis, who required surgical treatment. The transfer of ceftizoxime in combination with ambroxol into the ethmoid cell mucosa was compared to that of ceftizoxime alone. Ethmoid cell mucosal concentrations of ceftizoxime 90-120 minutes after intravenous administration of 1g of ceftizoxime alone ranged from 0.21 to 14.3μg/g. Plasma concentrations ranged from 9.51 to 31.6μg/ml, and the tissue distribution rate (ethmoid cell mucosal c./plasma c.) was 31%. When ambroxol was administered in combination with ceftizoxime, ethmoid cell mucosal concentrations of ceftizoxime ranged from 1.04 to 9.66μg/g. Plasma concentrations ranged from 6.7 to 33.5μg/ml, and the tissue distribution rate was 38%. In patients administered ceftizoxime alone, the tissue distribution rates of ceftizoxime were comparatively variable. The mean distribution rates however, were nearly the same in both groups. On the basis of these findings, it was concluded that the concentrations of ceftizoxime in the ethmoid cell mucosa and the plasma were scarcely affected even when ceftizoxime was administered in combination with ambroxol. Ethmoid cell mucosal concentrations and plasma concentrations of ceftizoxime are typically maintained at MIC80 values for period of 4 hours or more, in the treatment of various clinical isolates including organisms causing respiratory infection. This suggests that the therapeutic effects of ceftizoxime can be obtained clinically even when it is used alone. Concomitant use of ambroxol is however, considered to be useful supplemental therapy since the antibacterial activity of ceftizoxime is supported by the improvements in sinusitis induced by ambroxol.

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